The role of cognitive impairment in psychosocial functioning in remitted depression

Knight, Matthew J.; Air, Tracy; Baune, Bernhard T.

doi:10.1016/j.jad.2018.04.051

Cited by 89 publications

(66 citation statements)

References 48 publications

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“…Third, we addressed associations between psychosocial functioning during the depressive episode and subsequent cognitive deficits. Previous research suggests that cognitive deficits contribute to impaired psychosocial functioning [22][23][24], which impacts on quality of life. Furthermore, cognitive deficits were found to mediate of decreased work performance, contributing to the overall cost attributable to MDD [25,26].…”

Section: Introductionmentioning

confidence: 99%

Cognitive functioning and lifetime major depressive disorder in UK Biobank

et al. 2020

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Background. Cognitive impairment associated with lifetime major depressive disorder (MDD) is well-supported by meta-analytic studies, but population-based estimates remain scarce. Previous UK Biobank studies have only shown limited evidence of cognitive differences related to probable MDD. Using updated cognitive and clinical assessments in UK Biobank, this study investigated population-level differences in cognitive functioning associated with lifetime MDD. Methods. Associations between lifetime MDD and cognition (performance on six tasks and general cognitive functioning [g-factor]) were investigated in UK Biobank (N-range 7,457–14,836, age 45–81 years, 52% female), adjusting for demographics, education, and lifestyle. Lifetime MDD classifications were based on the Composite International Diagnostic Interview. Within the lifetime MDD group, we additionally investigated relationships between cognition and (a) recurrence, (b) current symptoms, (c) severity of psychosocial impairment (while symptomatic), and (d) concurrent psychotropic medication use. Results. Lifetime MDD was robustly associated with a lower g-factor (β = −0.10, PFDR = 4.7 × 10−5), with impairments in attention, processing speed, and executive functioning (β ≥ 0.06). Clinical characteristics revealed differential profiles of cognitive impairment among case individuals; those who reported severe psychosocial impairment and use of psychotropic medication performed worse on cognitive tests. Severe psychosocial impairment and reasoning showed the strongest association (β = −0.18, PFDR = 7.5 × 10−5). Conclusions. Findings describe small but robust associations between lifetime MDD and lower cognitive performance within a population-based sample. Overall effects were of modest effect size, suggesting limited clinical relevance. However, deficits within specific cognitive domains were more pronounced in relation to clinical characteristics, particularly severe psychosocial impairment.

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Section: Introductionmentioning

confidence: 99%

Cognitive functioning and lifetime major depressive disorder in UK Biobank

et al. 2020

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“…[14][15][16] Such symptoms have been shown to negatively impact both clinical and functional outcomes in patients with MDD, including HRQoL and work productivity. [17][18][19][20][21][22][23][24][25][26][27][28] However, data are lacking concerning the impact of cognitive symptoms on HRQoL and work productivity in Chinese patients with MDD. The Prospective Research Observation to Assess Cognition in Treated patients with MDD (PROACT) study was undertaken to evaluate the prevalence and course of cognitive symptoms in Chinese patients initiating new antidepressant treatment in a real-world setting.…”

Section: Introductionmentioning

confidence: 99%

<p>Impact of Cognitive Symptoms on Health-Related Quality of Life and Work Productivity in Chinese Patients with Major Depressive Disorder: Results from the PROACT Study</p>

Wang¹,

Tan²,

Ren³

et al. 2020

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Purpose: This post hoc analysis was undertaken to further explore the association of cognitive symptoms with health-related quality of life (HRQoL) and work productivity at the time of treatment initiation in Chinese patients with major depressive disorder (MDD) in the Prospective Research Observation to Assess Cognition in Treated patients with MDD (PROACT) study. Patients and Methods: This was an epidemiological, non-interventional, prospective cohort study in adult outpatients with moderate-to-severe MDD initiating antidepressant monotherapy (first or second line). Crude and adjusted analyses of covariance were performed to assess the association of perceived cognitive symptoms (20-item Perceived Deficits Questionnaire-Depression [PDQ-D] total score) or observed cognitive performance (Digit Symbol Substitution Test [DSST] score) with HRQoL (EuroQoL 5-Dimensions Questionnaire index) and work productivity (Work Productivity and Activity Impairment [WPAI] or Sheehan Disability Scale [SDS] absenteeism and presenteeism scores). Adjusted analyses included depression severity, age, sex, residential area (urban/rural), and educational level. Results: Of 1008 patients enrolled in the PROACT study, 986 were included in this analysis. Severity of perceived cognitive symptoms (ie, higher PDQ-D total score) was significantly associated with worse HRQoL (P<0.001) and higher levels of absenteeism (P=0.020 for the WPAI and P=0.002 for the SDS) and presenteeism (P<0.001 for both scales). The association of perceived cognitive symptoms with HRQoL and presenteeism was independent of depression severity. The association between observed cognitive performance (DSST score) and HRQoL was less robust. No association was seen between observed cognitive performance and levels of absenteeism or presenteeism assessed by either scale. Conclusion: Results of this real-world study illustrate the impact of cognitive symptoms on HRQoL and work productivity in Chinese patients with MDD, and highlight the importance of assessing and targeting cognitive symptoms in order to improve functional outcomes when treating patients with MDD.

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“…Specifically, relationships have been identified between several cold cognitive domains (i.e., executive, attention, and memory dysfunction) and issues in occupational functioning, interpersonal relationships, and self‐perceived quality of life (Caldirola et al., ; Evans et al., ; Kim et al., ; Knight & Baune, ; McIntyre et al., ). Psychosocial issues associated with MDD often persist in symptomatically recovered (i.e., remitted) patients, and are associated with illness relapse (Bortolato, Carvalho, & McIntyre, ; Cambridge et al., ; Knight, Air, & Baune, ; Miller et al., ), highlighting a need for greater clinical understanding and improved treatment of issues underlying psychosocial dysfunction. As cold cognition interacts with and is a core component of social cognition, it is reasonable to predict that social cognitive issues could also contribute independently to functional deficits in MDD.…”

Section: Introductionmentioning

confidence: 99%